Individual
JENNIFER DIANE JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2447 CALIFORNIA RD, PEKIN, IL 61554-8467
(309) 397-2362
Mailing address
2447 CALIFORNIA RD, PEKIN, IL 61554-8467
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146006705
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146006705
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
08/30/2017
Last updated
08/30/2017
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